Nutritional Analysis

Once you have purchased your Complete Nutritional Evaluation, please complete the following form for your personal nutritional analysis.

Note: Please include everything you eat and drink for three days as accurately as possible. Also include coffee, alcoholic beverages, soda, candy bars, etc., and estimated serving sizes whenever possible. Try to be specific, e.g. instead of writing 1 cup of milk, specify if the milk was low fat or 2%. Explain in detail how the food was prepared, e.g., instead of writing 1 chicken breast, describe how the chicken was prepared, if fried or baked, what kind of oil was used, if it was breaded etc.

Answer the following questions to the best of your ability. If you’re not sure of something, leave it blank and discuss it with your nutritional consultant. Serving size generally equals one cup or 3.5 ounces. These figures don’t have to be exact, just give the most accurate guess that you can.

(beans, fish, skinless chicken breast)
(bran, whole grains, starchy vegetables)
(Your Consultant can help you determine this)
(candy bars, donuts, cakes etc.)
(salami, ham, wieners, sausages, bologna etc.)
(vitamins, minerals, digestive enzymes, amino acids, herbs)
(mark as many as applies)
(Your Consultant can supply you with a Candida Questionnaire.)